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Community Health Systems officials described the settlement as reflecting the company’s ‘desire to end the investigation.’ THE CITIZENS’ VOICE FILE

Wilkes-Barre General Hospital and Berwick Hospital Center were among Community Health Systems’ 119 hospitals investigated for allegedly overbilling the federal government’s Medicare and Medicare programs, according to a settlement agreement U.S. Department of Justice provided.

The Department of Justice entered the settlement with Franklin, Tenn.-based Community Health Systems, which agreed to pay $98.15 million to resolve overbilling allegations.

Community Health Systems officials said the settlement reflects the company’s “desire to end the investigation, which began in 2011, and to avoid the significant expense and distraction of litigation,” according to a press release provided by spokeswoman Karen Litterer.

“Under the terms of the agreement, there is no finding of improper conduct by Community Health Systems or its affiliated hospitals, and the company has denied any wrongdoing,” the press release stated.

Multiple lawsuits were filed against Community Health Systems alleging the company knowingly billed Medicare, Medicaid and TRICARE for inpatient services from January 2005 to December 2010 that should have been billed as outpatient or observation services.

The company previously established a $102 million reserve to cover settlements and related legal costs, according to the press release.

Wayne T. Smith, chairman and chief executive officer of Community Health Systems, said the question of when a patient should be admitted to a hospital “is, and always has been, a matter of medical judgment by the individual physician responsible for a patient’s care.”

“Unfortunately, shifting and often ambiguous standards make it extremely difficult for physicians and hospitals to consistently comply with the regulations,” Smith said in a statement.

“We are committed to doing our best, despite these challenges,” he added. “Because this is an industry-wide issue, we hope the government will work to devise sound and reasonable rules for the important decision about whether or not to admit an individual for inpatient care, and we appreciate the opportunity to engage in meaningful dialogue with the government over these incredibly complicated issues.”

The Pennsylvania Association of Staff Nurses and Allied Professionals, the union which represents Wilkes-Barre General Hospital’s registered nurses in a labor dispute, released a statement Tuesday saying the patients, many of whom are elderly family members and neighbors, “will suffer at the hands of such illegal and immoral billing practices.”

CHS’ recent $98.15 million settlement is “rooted in the basic philosophy of this company to put their bottom-line profits first, regardless of the law or patients’ needs,” the nurses said.

“When the profits of a company are what drive all decision-making, corners will inevitably be cut to please company executives and Wall Street,” their statement read. “This is what happens when for-profit companies like CHS acquire and operate hospitals like Wilkes-Barre General Hospital.”

Community Health Systems purchased Wyoming Valley Health Care System, the former non-profit operator of Wilkes-Barre General Hospital, five years ago for $271 million.

Nurses said they object, and have always objected, to the sort of billing practices investigated, including the corporate practice of bill payment at the patients’ bedside. Such practices did not exist in the hospital until CHS took over, they said.

“We are equally concerned that this may only be the tip of the iceberg,” the nurses’ statement read. “Many believe that CHS has systematically broken its promises, including its promise to maintain charity care policies that were in place when they acquired the hospitals they now own in Pennsylvania.”

“PASNAP strongly urges Community Health Systems to act more responsibly towards our community by putting patients before profits, and putting nurses at the bedside instead of bill collectors.”

The nurses returned to work after participating in a five-day strike outside Wilkes-Barre General Hospital, but they still don’t have a contract.

Community Health Systems is one of the largest publicly-traded hospital companies in the U.S. and the leading operator of acute care hospitals across the country.

The company currently owns, leases or operates 206 affiliated hospitals in 29 states with about 31,100 licensed beds.

dallabaugh@citizensvoice.com, 570-821-2115

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